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RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

 

In consideration of eFun WestO, LLC dba Pedego Electric Bikes West Omaha (“Pedego West Omaha”) and its employees, officers, directors, and affiliates (the “RELEASEES”) agreeing to my participation in one or more bicycle rides and/or my use of a bicycle or equipment owned or operated by the RELEASEES (collectively, the “Equipment”) I hereby agree as follows:

 

1. TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the RELEASEES from any and all liability for any loss, damage, expense or injury, including death, that I may suffer or that my next of kin may suffer, as a result of my participation in one or more bicycle rides and/or my use of the Equipment, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, or in respect of the provision of or the failure to provide any warnings, directions, instructions or guidance as to my participation in any bicycle ride or my use of the Equipment;

 

2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES for any and all liability for any property damage, loss or personal injury to any third party resulting from my participation in any bicycle ride or my use of the Equipment.

 

3.This Release Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity.

 

4. This Release Agreement and any rights, duties, and obligations as between the parties to this Release Agreement shall be governed by the interpreted solely in accordance with the laws of the province of and no other jurisdiction; and

 

5. Any claim or litigation involving the parties to the Release Agreement shall be brought solely within the Commonwealth of Virginia and shall be within the exclusive jurisdiction of the Courts of that state.

 

In entering into this Release Agreement, I am not relying on any oral or written representations or statements made by the RELEASEES with respect to the safety of participating in any bicycle ride or my use of the Equipment, other than what is set forth in this Release Agreement.

 

I confirm that I am entering into this agreement voluntarily. I confirm that I have been advised to always wear a bicycle helmet while riding the bicycle.

 

I warrant that I am competent to ride safely and that my bicycle and equipment are in safe working condition. I agree to obey all traffic laws and to practice safety and courtesy when cycling.

 

I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Address

Full Address
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Address

Full Address
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Address

Full Address
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Address

Full Address
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Address

Full Address
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Address

Full Address
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Address

Full Address
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Address

Full Address
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Address

Full Address
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Address

Full Address
Parent or Guardian's Email Address

Email*

Confirm Email*
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Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Address

Full Address
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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